Though the bill doesn't specify a transvaginal ultrasound, in which a several-inch-long probe is inserted through the birth canal to the woman's uterus, that's exactly what Indiana would be requiring because of the early age of the fetus, said Dr. John Stutsman, an Indiana University School of Medicine professor and obstetrician-gynecologist.

Eight states - Alabama, Arizona, Florida, Kansas, Louisiana, Mississippi, Texas and Virginia - now require women who have an abortion to have an ultrasound, some of which are transvaginal, according to the Guttmacher Institute, which monitors sexual and reproductive health issues in state legislatures. Two other states, North Carolina and Oklahoma, have passed mandatory-ultrasound laws that courts have suspended pending challenges.

Last year, Virginia lawmakers' efforts to require transvaginal ultrasounds before an abortion generated such adverse publicity that the state's governor asked the General Assembly to amend its bill to make sure that no woman would have to have such an ultrasound involuntarily.

Ultrasound bills have been introduced in nine states this year, the institute said. The Arkansas Senate approved a bill last month prohibiting abortion if a fetal heartbeat is detectable via a transvaginal ultrasound, which if it becomes law, would be the earliest point in a pregnancy in which abortion would be banned.

The ultrasound provision included in Indiana Senate Bill 371 also would require any clinic that dispenses the drug known as RU-486 to meet the same requirements as a clinic that performs surgical abortions though physicians' offices would be exempt.

Those requirements potentially would force the Planned Parenthood clinic in Lafayette, Ind., to close, opponents say. That clinic offers the abortion pill but does not perform surgical abortions. If the bill passes, the clinic would have to widen hallways and doorways to meet state specifications for surgery and install anesthesia, surgical and sterilization equipment.

Indiana Sen. Travis Holdman, a Republican from Markle, Ind., who wrote the bill, said the measure is intended to ensure women's safety.

Pushing back against senators Wednesday who questioned why the heightened standards would apply only to RU-486 and not to other prescription medicines dispensed in clinics, Holdman said abortion is different.

It involves "another human life," he said.

But the bill's opponents said it jeopardizes the lives of Indiana women by making the drug harder to get, leading some to get unsafe drugs from the Internet.

Ultrasounds are not considered medically necessary for first-trimester abortions, the Guttmacher Institute says.

"The requirements appear to be a veiled attempt to personify the fetus and dissuade a woman from obtaining an abortion," its policy paper says. Mandatory ultrasounds, often not covered by insurance, also can add significantly to the cost of a procedure.

Stutsman and Dr. Brownsyne Tucker Edmonds, who also teaches at IU's Medical School, said the measure would require invasive, unnecessary ultrasounds. Under the bill, any physician prescribing an abortion-inducing drug would have to do an examination, including an ultrasound, and schedule a follow-up appointment that includes a second ultrasound to confirm the pregnancy was terminated.

While the woman is not required to keep that appointment, the physician must make a "reasonable effort" to ensure she does.

In his testimony, and in a letter Edmonds sent to the committee, both said better methods to determine if a woman is still pregnant after any attempted abortion, including blood and urine tests.

"I can only assume that the ultrasound mandate - a mandate for a costly, invasive test that confers no medical benefit to the woman subjected to it - speaks to the lack of clinical understanding and expertise of the authors of the bill," Edmonds wrote. "If not for lack of understanding, I would have to conclude that the mandate speaks to a lack of regard for the bodily sanctity and integrity of Hoosier women at large."

RU-486 is typically given in the earliest weeks of pregnancy, up to about nine weeks, Stutsman said.

Because of the small size of the uterus at that time in the pregnancy, he said a transvaginal ultrasound provides the best image. A regular ultrasound, taken over the skin of the abdomen, provides a better image at about 10 weeks.

Indiana law already requires those who perform surgical abortions to give ultrasounds to their patients although the Guttmacher Institute's list considers the law to require offering ultrasounds to women. Betty Cockrum, head of Planned Parenthood in Indiana, said about a third of those are early enough that they require a transvaginal ultrasound.

Attempts to reach Holdman after the hearing to determine whether he intended women obtaining RU-486 to undergo the more invasive transvaginal procedure were unsuccessful.

But at the hearing, he and supporters of the bill, including Indiana Right to Life, argued that drug-induced abortion is dangerous and should be regulated.

"I realize bills of this nature, folks have very firm beliefs on what we should or shouldn't be doing," Holdman said. "We are not requiring or practicing medicine without a license as some have alleged. ... We're just trying to control and regulate abortion-inducing drugs, which heretofore have not been regulated by the state of Indiana. I don't believe we're asking for anything that's unreasonable. We're talking about the life of the mother and the child."

Sue Swayze, legislative director for Indiana Right to Life, said RU-486 has become more prevalent as fewer doctors perform surgical abortions, but any physician can prescribe this drug.

Surgical abortions have a lower failure rate than those induced by a drug, she said.

"I'm not here to pitch surgical abortions by any stretch of the imagination," she said. "But if a woman's choosing that abortion, I'd much rather choose to see her choose a safer surgical abortion."

The senators were read a letter from a New York woman, identified only as Leslie, who said she had an abortion from RU-486 and that it caused her "the worst pain I've ever felt in my life" and lasting emotional pain.

"RU-486 is not a simple solution to a problem. It is a horrible drug," she wrote, urging senators to make it harder to obtain.

Others, though, told the senators that the drug is safe.

"In reality, the medication has a lower medical incidence rate than taking Tylenol," said Reba Boyd Wooden, executive director for the Center for Inquiry Indiana.

And Dr. Sue Ellen Braunlin, an anesthesiologist, called the bill "a fraud."

"It creates a health risk in a nearly risk-free treatment, and it does so to exert social control," she said.

By decreasing the number of providers who prescribe the pill or whose clinics do not meet the surgical standards in the bill, she predicted people will go online and obtain unsafe medications.

The committee also passed SB 489, authored by Sen. Mike Young, R-Indianapolis, which among other things mandates that clinics give women the already-required informed consent form, including illustrations, in color and not in black and white. Young said the bill also removes a provision in state law that requires women to listen to the fetal heartbeat.

"I don't want to force anybody to do anything against their will," Young said.